Can Children with Sexual Behavior Problems Live with Other Children?

With appropriate treatment and careful supervision, most children with problematic sexual behaviors can live safely with other children. The safety and well-being of all the children should be evaluated when making decisions about where children should live. Placement is not determined by a single factor. Instead, a number of factors need to be evaluated for placement decisions. These factors include:

How well the caregivers can provide close visual supervision and can respond to the needs of all the children.

What safety measures can be added to the home environment to increase the level of supervision and safety (for example, sleeping arrangements may need to be changed).

Whether or not the child has demonstrated sexual behavior problems with his or her siblings or other children in the home. In those cases, the reactions and responses of the other children need to be assessed.

How severe the child’s problematic sexual behaviors are and how well the child is responding to supervision and treatment. Children with highly aggressive or intrusive sexual behavior, despite treatment and close supervision, should not live with other young children until this behavior is resolved.

All the children can often remain in the home environment when a caregiver understands and is capable of providing the needed supervision and oversight, when the child responds to supervision and parenting strategies with reduced problematic sexual behaviors, and when the other children want to remain with their sibling and do not have strong feelings of fear or anxiety.

Alternative placements will need to be found when a caregiver is incapable of providing supervision (due to something like an addiction to drugs), when the child continues to demonstrate repeated, aggressive problematic sexual behaviors despite supervision, or when other children are experiencing significant distress about continuing to live with the child who acted out sexually. Ideally, caregivers in the alternative placements will

be actively involved in effective treatment services;

provide the least restrictive environment that also provides the needed safety measures;

be part of the natural community of the youth and the youth’s family;

limit the number of other changes in the child’s life (such as school placement or after-school activities)

be involved in the plan to transition the child back to his/her home environment as soon as possible with appropriate safety measures and consideration of the well-being of all the children involved.

Decisions regarding exactly when to return children with problematic sexual behaviors to their homes and to their parents and siblings are largely based on the same factors. It can only happen when the caregiver is capable of providing the right parenting, the child is responding to supervision and outpatient treatment, and the siblings are responsive to living together with the child again.

Such a reunification process must be individualized. Steps to enhance the success of the reunification include:

The caregiver’s direct involvement in the treatment of all the children.

The existence of well-developed supervision and safety plans with the caregiver and the children. The safety plan should be discussed with the entire family. The members must agree, understand, and be capable of following the plan (suggestions for safety plans are provided below).

The holding of meetings with family members to discuss the safety plan and the transition home.

Visits in the home, in natural family situations, with increasing frequency and duration as the children and caregivers successfully implement the safety plan.

The child’s move back home, with continuing involve­ment and support provided by the behavior-health provider/therapist for all family members.

Components of the Safety Plan

Safety plans are more likely to be needed with older children who have had aggressive or coercive problematic sexual behaviors. The safety plan includes

Rules for the children;

Activities the children can do and are encouraged to be able to do;

Responsibilities of the caregivers in charge of the children in the home; and

the family’s rules regarding privacy and supervision.

The following provides a framework for developing a safety plan. A qualified professional should assist in individualizing the plan for the family circumstances.

Rules for the Children

My child, ______________________, will learn and obey these rules:

Will not babysit for any amount of time.

Will not go into his/her brothers’ and sisters’ bedrooms without adult supervision. If he/she is invited into one of their bedrooms, the child will say, “No,” and go tell an adult.

Will not have his/her brothers or sisters come into his/ her bedroom, unless an adult is notified and is in the room to keep an eye on things.

Will not be in the bathroom if one of his/her brothers or sisters is in there. (Only one person can go into the bathroom at a time.)

Will keep the bathroom door closed when in there.

Will not engage in any “horseplay,” wrestling, or tickling with brothers, sisters, or any other young children.

Will not watch any movies, TV shows, or Internet material or listen to music that his/her parents have not approved.

Will not talk about sexual things or make any sexual comments or sexual jokes around his/her brothers, sisters, or other children.

Will not be alone with other children.

Some things my child can do at home—if it’s OK with her brothers, sisters, and parents—are

Watch approved TV, read, listen to music, or play sports or games with his/her brothers and sisters.

Sit next to brothers or sisters on the couch.

Talk and joke politely with brothers and sisters.

Go to church, to the store, or on family outings with the family.

Ride in the car with the family.

Eat meals or go to restaurants with the family.

Show appropriate affection to brothers and sisters if the brothers/sisters initiate it and if one of the parents is there to watch. Then hugs may be OK.

Rules for the Family

I, as the caregiver, agree to:

Supervise interactions between my child and all other involved children, including brothers and sisters.

Not ask my child to babysit.

Make sure that an informed, responsible adult is always in charge of the children.

Monitor my child’s activities, such as school work, homework, types of friends, and whereabouts, etc., and help my child make good choices.

Help my child to follow the rules by reminding him/ her about them, if he/she needs it.

Make sure that all the children are clothed unless they are in their own room with the door closed, in the bathroom with the door closed, or in bed.

Be open and accepting when talking with my child about any sexual questions or thoughts he/she might have.

The family agrees to:

Treat each other with respect.

Respect the authority of the parents/caregivers and follow their house rules

Listen to each other.

Be kind to each other.

Dress respectfully.

Have fun activities with each other.

Provide individual time for each child to talk privately with parents about important matters, including questions about relationships.

Help each other to be successful and to follow the rules of the family.

The family is encouraged to develop and individualize its safety plan with the guidance of a behavioral-health professional.

Can Children Who Have Had Problematic Sexual Behaviors Attend School with Other Children?

Most children who have had problematic sexual behaviors can attend school in their community and participate in school activities without putting the safety of other students at risk. Children with serious, aggressive sexual behaviors— who are unresponsive to outpatient treatment and supervision—may need a more restrictive environment.

In some cases, school personnel may need to know information for safety and protection issues. When the sexual behavior has occurred in school settings, where the child is assessed to have many risk factors or where the serious sexual behavior continues, it is appropriate to notify school personnel. When school personnel are notified, we recommend that accurate information be provided in addition to concrete recommendations. For example, recommendations for teachers may include changing bathroom breaks so that the child can use the bathroom alone. The recommendations should also include the provision of additional supervision during the more unstructured times (such as at recess and lunchtime). Notifying other children or children’s parents at the school is unnecessary. Such notifications may have a negative impact on the child, potentially causing the child to be isolated from or rejected by peers. Alerting school personnel regarding problematic sexual behaviors is not always necessary, particularly when the child’s sexual behavior has not occurred in the school settings, when the child is currently receiving treatment for his problematic sexual behaviors, or when the behavior was focused elsewhere and not ongoing.

Tips to Remember

1

With close supervision and safety planning, most children with problematic sexual behavior can live with other children.

2

The safety and well-being of all the children must be considered when making placement decisions.

3

Safety plans include rules for the children, responsibilities of the caregivers, and activities the children can do together.

4

Most children with problematic sexual behavior can safety attend school in their community and do not need specialized school environments.

An affiliate of OUHSC, funded by the Department of Justice, ojjdp federal grant number 01-JR-BX-K002
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